This role supports negotiations and cross-functional teams from home. The ideal candidate has a Bachelor's in Business/Finance or health field, 3+ years in PBM auditing or claim adjudication, and ...
New
This role supports negotiations and cross-functional teams from home. The ideal candidate has a Bachelor's in Business/Finance or health field, 3+ years in PBM auditing or claim adjudication, and ...
New
This role supports negotiations and cross-functional teams from home. The ideal candidate has a Bachelor's in Business/Finance or health field, 3+ years in PBM auditing or claim adjudication, and ...
New
This role supports negotiations and cross-functional teams from home. The ideal candidate has a Bachelor's in Business/Finance or health field, 3+ years in PBM auditing or claim adjudication, and ...
New
Work from Home
Boise, ID · Remote
$18/hr
We are excited to announce that currently we are looking for a 100% remote (work from home-WFH) ... Experience in medical claim processing is a plus * Bi-lingual (English/Spanish) is a plus The pay ...
Work from Home
Boise, ID · Remote
$18/hr
We are excited to announce that currently we are looking for a 100% remote (work from home-WFH) ... Experience in medical claim processing is a plus * Bi-lingual (English/Spanish) is a plus The pay ...
Work from Home
Tucson, AZ · Remote
$18/hr
We are excited to announce that currently we are looking for a 100% remote (work from home-WFH) ... Experience in medical claim processing is a plus * Bi-lingual (English/Spanish) is a plus The pay ...
Work from Home
Tucson, AZ · Remote
$18/hr
We are excited to announce that currently we are looking for a 100% remote (work from home-WFH) ... Experience in medical claim processing is a plus * Bi-lingual (English/Spanish) is a plus The pay ...
Work from Home
Grand Junction, CO · Remote
$18/hr
We are excited to announce that currently we are looking for a 100% remote (work from home-WFH) ... Experience in medical claim processing is a plus * Bi-lingual (English/Spanish) is a plus The pay ...
Work from Home
Grand Junction, CO · Remote
$18/hr
We are excited to announce that currently we are looking for a 100% remote (work from home-WFH) ... Experience in medical claim processing is a plus * Bi-lingual (English/Spanish) is a plus The pay ...
Work from Home
Cleveland, OH · Remote
$18/hr
We are excited to announce that currently we are looking for a 100% remote (work from home-WFH) ... Experience in medical claim processing is a plus * Bi-lingual (English/Spanish) is a plus The pay ...
Work from Home
Cleveland, OH · Remote
$18/hr
We are excited to announce that currently we are looking for a 100% remote (work from home-WFH) ... Experience in medical claim processing is a plus * Bi-lingual (English/Spanish) is a plus The pay ...
Work from Home
Cincinnati, OH · Remote
$18/hr
We are excited to announce that currently we are looking for a 100% remote (work from home-WFH) ... Experience in medical claim processing is a plus * Bi-lingual (English/Spanish) is a plus The pay ...
Work from Home
Cincinnati, OH · Remote
$18/hr
We are excited to announce that currently we are looking for a 100% remote (work from home-WFH) ... Experience in medical claim processing is a plus * Bi-lingual (English/Spanish) is a plus The pay ...
Work from Home
Fort Collins, CO · Remote
$18/hr
We are excited to announce that currently we are looking for a 100% remote (work from home-WFH) ... Experience in medical claim processing is a plus * Bi-lingual (English/Spanish) is a plus The pay ...
Work from Home
Fort Collins, CO · Remote
$18/hr
We are excited to announce that currently we are looking for a 100% remote (work from home-WFH) ... Experience in medical claim processing is a plus * Bi-lingual (English/Spanish) is a plus The pay ...
Work from Home
Indianapolis, IN · Remote
$18/hr
We are excited to announce that currently we are looking for a 100% remote (work from home-WFH) ... Experience in medical claim processing is a plus * Bi-lingual (English/Spanish) is a plus The pay ...
Work from Home
Indianapolis, IN · Remote
$18/hr
We are excited to announce that currently we are looking for a 100% remote (work from home-WFH) ... Experience in medical claim processing is a plus * Bi-lingual (English/Spanish) is a plus The pay ...
Work from Home
Littleton, CO · Remote
$18/hr
We are excited to announce that currently we are looking for a 100% remote (work from home-WFH) ... Experience in medical claim processing is a plus * Bi-lingual (English/Spanish) is a plus The pay ...
Work from Home
Littleton, CO · Remote
$18/hr
We are excited to announce that currently we are looking for a 100% remote (work from home-WFH) ... Experience in medical claim processing is a plus * Bi-lingual (English/Spanish) is a plus The pay ...
Work from Home
Norfolk, VA · Remote
$18/hr
We are excited to announce that currently we are looking for a 100% remote (work from home-WFH) ... Experience in medical claim processing is a plus * Bi-lingual (English/Spanish) is a plus The pay ...
Work from Home
Norfolk, VA · Remote
$18/hr
We are excited to announce that currently we are looking for a 100% remote (work from home-WFH) ... Experience in medical claim processing is a plus * Bi-lingual (English/Spanish) is a plus The pay ...
Work from Home
North Little Rock, AR · Remote
$18/hr
We are excited to announce that currently we are looking for a 100% remote (work from home-WFH) ... Experience in medical claim processing is a plus * Bi-lingual (English/Spanish) is a plus The pay ...
Work from Home
North Little Rock, AR · Remote
$18/hr
We are excited to announce that currently we are looking for a 100% remote (work from home-WFH) ... Experience in medical claim processing is a plus * Bi-lingual (English/Spanish) is a plus The pay ...
Work from Home
Colorado Springs, CO · Remote
$18/hr
We are excited to announce that currently we are looking for a 100% remote (work from home-WFH) ... Experience in medical claim processing is a plus * Bi-lingual (English/Spanish) is a plus The pay ...
Work from Home
Colorado Springs, CO · Remote
$18/hr
We are excited to announce that currently we are looking for a 100% remote (work from home-WFH) ... Experience in medical claim processing is a plus * Bi-lingual (English/Spanish) is a plus The pay ...
Work from Home
Little Rock, AR · Remote
$18/hr
We are excited to announce that currently we are looking for a 100% remote (work from home-WFH) ... Experience in medical claim processing is a plus * Bi-lingual (English/Spanish) is a plus The pay ...
Work from Home
Little Rock, AR · Remote
$18/hr
We are excited to announce that currently we are looking for a 100% remote (work from home-WFH) ... Experience in medical claim processing is a plus * Bi-lingual (English/Spanish) is a plus The pay ...
Work from Home
Albuquerque, NM · Remote
$18/hr
We are excited to announce that currently we are looking for a 100% remote (work from home-WFH) ... Experience in medical claim processing is a plus * Bi-lingual (English/Spanish) is a plus The pay ...
Work from Home
Albuquerque, NM · Remote
$18/hr
We are excited to announce that currently we are looking for a 100% remote (work from home-WFH) ... Experience in medical claim processing is a plus * Bi-lingual (English/Spanish) is a plus The pay ...
Work from Home
Louisville, KY · Remote
$18/hr
We are excited to announce that currently we are looking for a 100% remote (work from home-WFH) ... Experience in medical claim processing is a plus * Bi-lingual (English/Spanish) is a plus The pay ...
Work from Home
Louisville, KY · Remote
$18/hr
We are excited to announce that currently we are looking for a 100% remote (work from home-WFH) ... Experience in medical claim processing is a plus * Bi-lingual (English/Spanish) is a plus The pay ...
Work from Home
Portland, OR · Remote
$18/hr
We are excited to announce that currently we are looking for a 100% remote (work from home-WFH) ... Experience in medical claim processing is a plus * Bi-lingual (English/Spanish) is a plus The pay ...
Work from Home
Portland, OR · Remote
$18/hr
We are excited to announce that currently we are looking for a 100% remote (work from home-WFH) ... Experience in medical claim processing is a plus * Bi-lingual (English/Spanish) is a plus The pay ...
Work from Home
Pittsburgh, PA · Remote
$18/hr
We are excited to announce that currently we are looking for a 100% remote (work from home-WFH) ... Experience in medical claim processing is a plus * Bi-lingual (English/Spanish) is a plus The pay ...
Work from Home
Pittsburgh, PA · Remote
$18/hr
We are excited to announce that currently we are looking for a 100% remote (work from home-WFH) ... Experience in medical claim processing is a plus * Bi-lingual (English/Spanish) is a plus The pay ...
Work from Home
Denver, CO · Remote
$18/hr
We are excited to announce that currently we are looking for a 100% remote (work from home-WFH) ... Experience in medical claim processing is a plus * Bi-lingual (English/Spanish) is a plus The pay ...
Work from Home
Denver, CO · Remote
$18/hr
We are excited to announce that currently we are looking for a 100% remote (work from home-WFH) ... Experience in medical claim processing is a plus * Bi-lingual (English/Spanish) is a plus The pay ...
Work from Home
Gilbert, AZ · Remote
$18/hr
We are excited to announce that currently we are looking for a 100% remote (work from home-WFH) ... Experience in medical claim processing is a plus * Bi-lingual (English/Spanish) is a plus The pay ...
Work from Home
Gilbert, AZ · Remote
$18/hr
We are excited to announce that currently we are looking for a 100% remote (work from home-WFH) ... Experience in medical claim processing is a plus * Bi-lingual (English/Spanish) is a plus The pay ...
Work From Home Claim Adjudication information
See salary details
$15.63 - $18.47
1% of jobs
$18.47 - $21.31
3% of jobs
$21.31 - $24.15
1% of jobs
$24.15 - $26.99
4% of jobs
$26.99 - $29.83
11% of jobs
$31.84 is the 25th percentile. Wages below this are outliers.
$29.83 - $32.67
6% of jobs
$32.67 - $35.51
16% of jobs
The median wage is $36.60 / hr.
$35.51 - $38.35
18% of jobs
$38.35 - $41.19
10% of jobs
$41.90 is the 75th percentile. Wages above this are outliers.
$41.19 - $44.03
16% of jobs
$44.03 - $46.88
13% of jobs
$15
$36
$46
How much do work from home claim adjudication jobs pay per hour?
As of Aug 29, 2026, the average hourly pay for work from home claim adjudication in the United States is $36.99, according to ZipRecruiter salary data. Most workers in this role earn between $31.49 and $42.79 per hour, depending on experience, location, and employer.
What is a work from home claim adjudication job?
Work From Home Claim Adjudication jobs involve reviewing and processing insurance claims remotely. Claim adjudicators examine claims to determine their validity and ensure they comply with policy guidelines and regulations. These professionals work for insurance companies or third-party administrators, using specialized software to analyze documents, communicate with clients, and authorize payments or denials. Working from home provides flexibility while still requiring strong attention to detail, confidentiality, and knowledge of insurance policies.
What are the key skills and qualifications needed to thrive as a work from home claim adjudicator?
To thrive as a Work From Home Claim Adjudicator, you need strong analytical skills, attention to detail, and a solid understanding of insurance policies or healthcare claims, often supported by relevant experience or certification. Familiarity with claims management systems, electronic documentation tools, and sometimes industry certifications like AIC or CPC are typically required. Excellent written communication, time management, and self-motivation are vital soft skills for remote work efficiency and collaboration. These skills and qualities are crucial for ensuring accurate claim processing, minimizing errors, and maintaining compliance in a virtual work environment.
What are some common challenges faced by remote claim adjudicators, and how can they be addressed?
Remote claim adjudicators often face challenges such as staying organized with high volumes of claims, maintaining effective communication with team members, and ensuring data security while working from home. To address these, it’s important to establish a structured daily routine, make use of secure company-provided systems, and participate in regular virtual meetings to stay connected with colleagues. Leveraging collaboration tools and adhering to best practices for data privacy can also help ensure accuracy and compliance in your work.
What is the difference between Work From Home Claim Adjudication vs Work From Home Claims Processor?
| Aspect | Work From Home Claim Adjudication | Work From Home Claims Processor |
|---|---|---|
| Credentials | Insurance or healthcare certifications, relevant licenses | Basic insurance knowledge, customer service skills |
| Work Environment | Home office, computer-based tasks, detailed review | Home office, data entry, customer interaction |
| Industry Usage | Insurance companies, healthcare providers | Insurance companies, third-party administrators |
| Job Focus | Assessing and approving insurance claims based on policies | Processing claims, data entry, customer support |
Work From Home Claim Adjudication involves evaluating insurance claims to determine approval based on policies and regulations, requiring specialized knowledge and certifications. In contrast, Work From Home Claims Processors handle the data entry and customer interactions related to claims, focusing on processing and documentation. Both roles are essential in the insurance industry but differ in responsibilities and required credentials.
More about Work From Home Claim Adjudication jobs
What cities are hiring for Work From Home Claim Adjudication jobs?
Cities with the most Work From Home Claim Adjudication job openings:
What states have the most Work From Home Claim Adjudication jobs?
States with the most job openings for Work From Home Claim Adjudication jobs include:
What job categories do people searching Work From Home Claim Adjudication jobs look for?
The top searched job categories for Work From Home Claim Adjudication jobs are:
Job description
6AM City, LLC is seeking a qualified PBM audit analyst to review pricing terms, plan designs and client contracts. You will leverage our Compliance Model to calculate financial guarantees, admin fees, rebates and related terms, and prepare audit findings for client discussions. This role supports negotiations and cross-functional teams from home. The ideal candidate has a Bachelor's in Business/Finance or health field, 3+ years in PBM auditing or claim adjudication, and solid Excel/SQL skills.
About 6AM City
Sourced by ZipRecruiter
Industry
Motion picture and video production
Company size
51 - 200 Employees
Headquarters location
Greenville, SC, US
Year founded
2016